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The HIV protease inhibitor indinavir is known to cause nephrolithiasis, but until recently other antiretroviral agents were not associated with this condition. After two cases of atazanavir-related kidney stones were described, researchers searched for more in the FDA’s Adverse Event Reporting System database. Their search yielded 28 additional cases of nephrolithiasis in HIV-infected patients taking atazanavir.
Of the 30 reported patients, 5 had a history of kidney stones, and 3 had preexisting renal disease. Atazanavir was detected in 12 of the 14 patients who had stone-composition analysis; drug concentration ranged from 40% to 100% in the 6 cases for which data were available. The median time between initiation of atazanavir and diagnosi…